TITLE 50: INSURANCE
CHAPTER VI: WORKERS' COMPENSATION COMMISSION
PART 9020 PRE-ARBITRATION
SECTION 9020.20 APPLICATION FOR ADJUSTMENT OF CLAIM


 

Section 9020.20  Application for Adjustment of Claim

 

a)         Applications for Adjustment of Claim (Application) with a certificate setting forth the date of service shall be filed in triplicate on an appropriate form provided by the Commission.  The filing party shall serve one copy of the Application that has been filed on all opposing parties.

 

b)         An Application must be limited to one accident or claim.  After an Application has been filed with the Commission, any other Applications for Adjustment of Claim covering that accident, but naming a different employer, shall be assigned the same docket number as the original Application.

 

c)         Applications shall be completed in full and must provide an accident or manifestation of injury date, a description of how the accident occurred, the part of the body injured, the geographical location of the accident for purposes of establishing venue, and a description of how notice of the accident was given or acquired by the employer.

 

d)         Once an Application is filed, the Commission will send the information on the Application, on a Notice of Hearing, to the opposing party at the address supplied by the filing party. If the Notice is returned to the Commission because the filing party has supplied the wrong address for the opposing party, the Commission will so inform the filing party.  The filing party has the obligation of providing the Commission with the proper address so Notice can be sent to the opposing party.

 

e)         Applications may be amended prior to a hearing on the merits by filing an Amended Application for Adjustment of Claim under the letter and number given the original Application. The Amended Application must be clearly labeled "Amended" with all changes clearly marked on all copies and must have attached to it all prior versions of the Application for Adjustment of Claim.  Also attached must be proof that the filing party has served a copy of the Amended Application on the opposing party in the manner set forth in Section 9020.70.  It shall be within the discretion of the Commission whether to allow any amendments to the Application after the commencement of a hearing on the merits.

 

(Source:  Amended at 40 Ill. Reg. 15709, effective November 9, 2016)